Payments Based on Value

After the CMS announcement in January of a major push towards value based care, we can expect private payers to follow this course aggressively as well. In our recent article Value for Independents, we suggest that rather than viewing value based as threat, this model can level the playing field for independent providers of care who are willing to re-think their business.

For the next few days, Sense Corp will offer up a few ideas for providers that not only want to survive, but thrive in the new value based world.

#1: Establish Strong Data Governance

Data must drive decisions at the clinical level. Well-applied technology is a “force-multiplier” for the clinician. An algorithm cannot replace good decision making, but it can reduce cognitive load and help stratify populations and thus prioritize efforts. What is critical is that information must be relevant, timely and delivered at the appropriate context.

What satisfies the requirements for good data warehousing may not serve the clinicians and other staff on the front lines in reports, or may be difficult to interpret. Pull in data sources first that help teams assess and execute on contract metrics; make the reports as individualized as possible, eliminate as many distractions from reports as you can. If the data is unreliable, consider how it can be augmented with staff or simply eliminated.